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ICF/DD-H (Habilitative)License activeMedi-Cal certified

WASHINGTON STREET GROUP HOME

ICF/DD-H (Habilitative) · 6 licensed beds · Lemon Grove, CA

Homes of 4–15 beds for people with developmental disabilities whose nursing needs are intermittent and predictable.

Address

WASHINGTON STREET GROUP HOME1938 WASHINGTON STLemon Grove, CA 91945 · San Diego County

Phone: (585) 410-5513

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-H (Habilitative)
Licensed beds
6
Licensee
THE ARC OF SAN DIEGO · Nonprofit Corp
Administrator
SOOMTHA, NATTHIDA
CDPH facility ID
090000485
License number
090000296
First licensed
October 22, 1986
Current license
Dec 22, 2025 to Dec 21, 2026
CDPH district office
San Diego

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
05G814
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
September 23, 1994
Last certification survey
July 10, 2025
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
Recertification
Ownership type (CMS)
Private (non-profit)
Certified beds (CMS)
6
Staffing reported to CMS
RN 0.15 · LVN/LPN 0 · direct care 6.3 · all employees 6.81

State citations and penalties (CDPH)

1 penalty, newest first

CDPH issues citations under Health and Safety Code §1424: Class AA (a violation that was a substantial factor in a resident's death), Class A (imminent danger or a substantial probability of death or serious harm) and Class B (a direct relationship to residents' health, safety or security). State citations explained

  • Class BPatient Rights

    Citation B (HSC 1424) · Violation Mar 6, 2006 · Penalty #090003020 · Survey DIP211

    Status: Closed · Not appealed

    $900

Federal inspections (CMS-2567)

59 surveys since 2018 · CMS data through Oct 12, 2026

CDPH surveys certified ICFs for CMS. Each deficiency is a W-tag (a federal ICF/IID requirement), an E-tag (emergency preparedness) or a K-tag (Life Safety Code), cited at the standard level or, more seriously, the condition level. How to read an ICF inspection

Content note: these federal findings describe residents' care and can include abuse, neglect, injuries and medical details. They're shown as CMS published them; residents are identified only by number (such as "Client 1").

  1. · Complaint

    Event 3EUP11 · no deficiencies cited

    Official 2567 ↗
  2. · Complaint

    Event BF4C11 · 1 deficiency

    Official 2567 ↗
  3. · Recertification

    Event 5JF321 · 1 deficiency

    Official 2567 ↗
  4. · Recertification

    Event 5JF311 · 2 deficiencies

    Official 2567 ↗
  5. · Complaint

    Event 7ETO11 · no deficiencies cited

    Official 2567 ↗
  6. · Complaint

    Event FTY711 · no deficiencies cited

    Official 2567 ↗
  7. · Complaint

    Event C1EU11 · no deficiencies cited

    Official 2567 ↗
  8. · Complaint

    Event PW9R11 · no deficiencies cited

    Official 2567 ↗
  9. · Recertification

    Event 50SY21 · 4 deficiencies

    Official 2567 ↗
  10. · Recertification

    Event 50SY11 · 8 deficiencies

    Official 2567 ↗
  11. · Complaint

    Event X2OU11 · no deficiencies cited

    Official 2567 ↗
  12. · Complaint

    Event R0P311 · no deficiencies cited

    Official 2567 ↗

From CMS's QCOR ICF/IID statement-of-deficiency download, saved Oct 26, 2026. CMS notes that ICF/IID data after March 19, 2026 may be incomplete while its systems migrate. Plans of correction and state-only (licensing) deficiencies aren't in that file; the official 2567 documents on CalHealthFind have them.

Complaints and reported incidents

CDPH doesn't publish complaints or facility-reported incidents as a bulk file, so they aren't on ICFLookup. Its CalHealthFind page for this facility lists them (intake date, allegation category and whether each was substantiated), along with state licensing deficiencies and ownership details.

Federal surveys that came from a complaint or an incident report do appear above, marked "Complaint" as the survey type.

Open this facility on CalHealthFind ↗How to file a complaint with CDPH

Change history

61 events, newest first

Dates marked "state record" are the agencies' own: the license date, federal survey dates and penalty issue dates. "Detected" changes are ones we noticed by comparing CDPH's monthly facility listing with the one before it, tracked since Oct 26, 2026.

  1. ReportFederal survey (complaint): no deficiencies(state record)

    See this survey →
  2. ReportFederal survey (complaint): 1 deficiency(state record)

    See this survey →
  3. ReportFederal survey (recertification): 1 deficiency(state record)

    See this survey →
  4. ReportFederal survey (recertification): 2 deficiencies(state record)

    See this survey →
  5. ReportFederal survey (complaint): no deficiencies(state record)

    See this survey →
  6. ReportFederal survey (complaint): no deficiencies(state record)

    See this survey →
  7. ReportFederal survey (complaint): no deficiencies(state record)

    See this survey →
  8. ReportFederal survey (complaint): no deficiencies(state record)

    See this survey →
  9. ReportFederal survey (recertification): 4 deficiencies(state record)

    See this survey →
  10. ReportFederal survey (recertification): 8 deficiencies(state record)

    See this survey →

Sources: CDPH Licensed and Certified Healthcare Facility Listing (data as of Oct 16, 2026), CDPH State Enforcement Actions, and CMS's ICF/IID statement-of-deficiency (CMS-2567) and Provider of Services files. ICFLookup is not affiliated with CDPH or CMS; always confirm with CDPH's CalHealthFind ↗ before making a decision. See How our data works.